Existing Wording: The narrative for a resource is allowed to contain additional information that is not in the structured data, including human-edited content.

Proposed Wording: The narrative for a resource is allowed to contain additional information that is not in the structured data, including human-edited content. The converse is not true: structured data should not contain information of importance to human readers that is omitted from the narrative. Creators of FHIR resources should not assume that systems will render, or that humans will see, data that is not in the narrative.

Comment:

The best practice of representing ALL human-relevant information in the narrative is important to avoid people missing it. No assumptions can be made about querying/receiving systems rendering. Recent problems surfaced regarding CDA instances where structured entries contained more information (e.g., additional lab results) than was in the narrative.