1. All of the arrows are bidirectional, so it's not clear what's flowing to whom
2. 'Provider' is not a useful name - there are providers in all of the organizations exchanging information. Need a more descriptive label - diagnosing provider, coordinating provider, something.
3. Some arrows are labeled, some not, but even those labeled don't make clear what the action is - e.g. "Condition Procedure" - what is that? How does it happen? Why is it needed?
4. Can the surveys flow over the FHIR interface?

Overall, this diagram doesn't help understand who this spec applies to, nor what the responsibilities of each system are, nor what information is expected to flow when - which is what the IG should be defining.

(Comment 99 - imported by: Robert Dieterle)