The definitions of Observation.issued and Diagnostic.issued leave confusion on what the actual purpose of these fields and that they need to be in sync more. The following are proposed updates to remove the ambiguity (suggestions bolded):

DiagnosticReport.issued

Definition - The date and time that this version of the report was *originally *released from the source diagnostic service.

Requirements - Clinicians need to be able to check the date that the report was *originally *released.

Alternate Names - Date Created; Date *Originally *Published; Date *Originally *Issued

Comments - May be different from the update time of the resource itself, because th*e update timeat* is the status of the record (potentially a secondary copy), not the originalactual release time of the report.

Observation.issued

Definition - The date and time this observation was *originally *made available to providers, typically after the results have been reviewed and verified.

Comments - Updated when the result is updated.

Provenance would then be clearly picking up any change dates from that point forward.