Comment:

If domain resource has strength=required on the binding then derived profiles cannot loosen the strength to extensible, though you can reduce the number of codes in the value set.

This is uncaught in the profile publishing tooling and the profile snapshot shows the overridden binding in the published DAF profiles. Tooling needs to catch and flag such an error.

This error is resulting in at least 3 HL7 FHIR profiles are defined with binding=extensible on bindings declared as required in the base resource.

For example, the snapshot view for daf-diagnosticorder profile with element DiagnosticOrder.item.code shows binding as being overridden which should not be allowed.

<binding>

<name value="USLabObservationName"/>

<strength value="extensible"/>

<description value="LOINC codes"/>

<valueSetReference>

<reference value="http://hl7.org/fhir/vs/obs-uslab-codes"/>

</valueSetReference>

</binding>

1. DiagnosticOrder.item.code

DiagnosticRequests* Required* http://hl7.org/fhir/vs/diagnostic-requests* (base)

USLabObservationName Extensible http://hl7.org/fhir/vs/obs-uslab-codes

2. DiagnosticReport.name

DiagnosticReportNames* Required* http://hl7.org/fhir/vs/report-names* (base)

USLabObservationName Extensible http://hl7.org/fhir/vs/obs-uslab-codes

3.Encounter.hospitalization.dischargeDisposition

DischargeDisp* Required* http://hl7.org/fhir/vs/encounter-discharge-disposition* (base)

DAFDischargeDispo Extensible http://hl7.org/fhir/vs/daf-encounter-dischargedisposition

FHIR publishing tools are not validating profiles that break conformance to the base resources and are publishing artifacts that are not valid with respect to the spec.