In context of https://jira.hl7.org/browse/FHIR-28375 we propose that the Reference list be limited to US Core Patient Profile rather than having it covered under the general “should” statement to use US Core profiles, while also indicating that Device, Location and Group are not supported as other choices.

For purposes of vital signs, the observation subject never can be device, location, or group, rather always is a patient.

As the FHIR US Core profile is used for accessing and exchanging data based on what the source system has, this should not require the data source system to add functionality to capture a device, location and group as part of the vital signs observation subject.  Additionally, C-CDA does not impose this requirement either.

While this JIRA is posted to US Core/Cross-Project Workgroup, we strongly urge the project to work with the Orders & Observations workgroup and FMG to resolve how to ease the restrictions put in the base profile to accommodate US Core requirements.

Links to pages:

http://hl7.org/fhir/us/core/STU3.1/index.html

https://build.fhir.org/ig/HL7/US-Core-R4/index.html

http://hl7.org/fhir/R4/observation-vitalsigns.html