In looking at the example, I realized there's no way to tell when the condition was last confirmed to still be true. Something might have an onset date of 3 years ago. But if the status and nothing else has changed, it's possible the record will be unchanged, even though you reviewed it yesterday and confirmed it yesterday. Alternatively, it's possible it hasn't been confirmed in years and is out of date. I've raised FHIR-30432. You might want to define an extension in the interim

(Comment 164 - imported by: Robert Dieterle)