It is not clear how this material is Hrex or US payor-to provider specific. The basis upon which re-use and Adoption is also not clear - this there some metric or is this aspirational? The separation between exchange and use of data is not clear and perhaps the intention is to focus of the work of the exchange not on the processing of the material exchanged.
Suggest that this material which looks to be well formed and have wider applicability be pulled from this guide, leaving the US usage guidance behind, so that it can be referred to by other US or non-US IGs.